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Yale Medical Society

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YALE MEDICAL SOCIETY November 14 OBSERVATIONS ON AN UNIDENTIFIED ORGANISM ISOLATED FROM CASES OF MENINGOENCEPHALITIS CASPAR G. BURN The present study began 18 months ago with the isolation of an uniden- tified organism from four cases of meningoencephalitis, 3 infants and a 56-year-old male. At the post-mortem examination the organism was obtained from all lesions in the last case in conjunction with Pneumococcus Type III. There were multiple foci of necrosis and exudation in the liver of all cases and in both adrenals of one case. Those cases in which the central nervous system was examined showed an extensive meningitis and in two cases an encephalitis. The organism is a Gram-positive, non-spore-forming rod appearing singly, in clumps, or in chains. The colonies resemble those of Streptococcus hemolyticus, differing in that they are larger, flatter, and with a smaller zone of hemolysis. The usual sugars except lactose and glycerine are fermented without gas production. Lactose and glycerine undergo late fermentation. The results with animal inoculation vary with the numbers introduced and with the route. Intravenous injections in rabbits of from 10,000 to 1,000,000 bacilli result in paralysis on the third or fourth day and death in 5 to 6 hours after paralysis. At autopsy the liver and central nervous system show the same lesions as do the human cases. Monkeys remain well until the third or fourth day and then show signs of involvement of the central nervous system but with no paralysis. On being sacrificed, there is present an extensive meningitis. Guinea pigs die in four to five days and at autopsy show a myocarditis and some pericarditis. Intraperitoneal injections of amounts larger than 1,000,000 caused in some cases a fatal septicemia with meningeal involvement. Carriers were not found in the patients' families. Other investigators have isolated the organism from cases of meningoencephalitis. The organism which produces a suppurative meningitis in cows seems to be identical with the

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